Every finding on record at Elite Home Care Solutions LLC

Upon patient record review, 3 of 14 (Patient #4,6,7) did not have evidence in the patient record that a review was completed of all prescription and non-prescription medications, including herbal remedies that could affect drug therapy. This review includes, but is not limited to: • Effectiveness of drug therapy • Drug side effects • Actual or potential drug interactions • Duplicate drug therapy • Drug therapy currently associated with laboratory monitoring Patient 4: On the medication profile there is an order for Polyethylene Glycol 17grams daily, there is no diluent listed in the instructions. Corrected on site. Patient 6: On the medication profile there is an order for Polyethylene Glycol 17grams daily, there is no diluent listed in the instructions. Corrected on site. Patient 7: On the hospice medication record there are medications that are not on the ALF medication record, Polyethylene Glycol 17gm daily and Prochlorperazine Maleate 10mg every 6 hours as needed. Corrected on site.

Upon patient record review, 2 of 14 (Patient #5,6) did not have evidence in the patient record that the hospice has developed an individualized written plan of care for each patient. The plan of care must reflect patient/family goals and interventions based on the problems identified in the initial, comprehensive, and updated comprehensive assessments. The plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions. Patient 5: On the initial RN assessment there is documentation, "Patient has a left chest Port a Cath that was flushed and hep locked prior to hospital d/c on 6/26/25". There are no orders on the plan of care with goals and interventions for the care of the port a cath. Corrected on site. Patient 6: On the patient plan of care there is an order for Aspirin 81mg daily, there is not a risk of bleeding on the plan of care with goals and interventions. Corrected on site.

Upon patient record review, 4 of 14 (Patient #2,4,6,8) did not have evidence the plan of care must include all services necessary for the palliation and management of the terminal illness and related conditions, including medications and treatments. Patient 2: On the plan of care there is an order for Medrol 4mg tablets in a dose pack, the dose state, "per instructions daily", there are not specific instructions per day for this medication. Corrected on site. Patient 4: On the plan of care there is an order for Polyethylene Glycol 17grams daily, there is no diluent listed in the instructions. Corrected on site. Patient 6: On the plan of care there is an order for Polyethylene Glycol 17grams daily, there is no diluent listed in the instructions. Corrected on site. Patient 8: On the plan of care there is an order for oxygen gas for inhalation 2-4 liters for dyspnea prn, there is not a route for the order. Corrected on site.

Upon personnel record review, 1 of 11 (Personnel # 4) did not have evidence in the personnel file that the following competency assessment was performed by the aide with a patient: (This standard applies to all Hospice Aides providing care/service who are directly employed by the hospice or through a contractual agreement.) ·(C) Shampoo, sink, tub, and bed Personnel 4: In the personnel file the aide competency includes "shampoo", there is not evidence in the competency assessment by the aide that appropriate techniques in personal hygiene and grooming included sink, tub and bed. Corrected on site with an addendum and Corporate training.